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Q16.3 ICD-10-CM Code: Congenital malformation of ear ossicles

Compare with another code for Q16.3Check this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
1 inclusion term · 1 Excludes1 · 7 Excludes2

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Excludes1from Q16Not reported with this code unless documented as unrelated
  • congenital deafness (H90.-)
Excludes2from Q10-Q18Not included here; may be reported together
  • cleft lip and cleft palate (Q35-Q37)
  • congenital malformation of cervical spine (Q05.0, Q05.5, Q67.5, Q76.0-Q76.4)
  • congenital malformation of larynx (Q31.-)
  • congenital malformation of lip NEC (Q38.0)

+3 more in Instructions

IncludesWhat this code covers
  • Congenital fusion of ear ossicles

Where it sits Source: CMS/NCHS

Under:Chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-QA1) (Q00-QA1)Q10-Q18 Congenital malformations of eye, ear, face and neckQ16 Congenital malformations of ear causing impairment of hearing

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 154 — OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC (MDC 03)
  • MS-DRG 155 — OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC (MDC 03)
  • MS-DRG 156 — OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC (MDC 03)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Q16.3 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on Q16.3 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Congenital fusion of ear ossicles

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from Q16

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from Q10-Q18

Coder workflow for Q16.3

MedCoder structured workflow — derived from this code’s own official record

Before you code Q16.3

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with Q16.3. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in Q16.3’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewH90

Consider Q16.3. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

  • Excludes1 — check before selecting Q16.3(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with Q16.3: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareH90

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of Q16.3(7 notes)

    Coding workflow: The conditions named in this note are not included in Q16.3. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareQ05.0, Q05.5, Q67.5, Q31, Q38.0, Q30

    See the official tabular notes · Guidelines I.A.12.b

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition Q16.3 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewH90

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse Q16.3 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of Q16.3 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • H90— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of congenital deafness moves the case to H90; the two are not reported together unless documented as unrelated.

    Full comparison: Q16.3 vs H90 →

  • Q16.9— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Congenital malformation of ear causing impairment of hearing, unspecified” takes Q16.9; specificity in the record moves it back here.

    Full comparison: Q16.3 vs Q16.9 →

  • Q35— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of cleft lip and cleft palate adds Q35; it is not part of this code and both may be reported when both are documented.

    Full comparison: Q16.3 vs Q35 →

  • Q37— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of cleft lip and cleft palate adds Q37; it is not part of this code and both may be reported when both are documented.

    Full comparison: Q16.3 vs Q37 →

  • Q05.0— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of congenital malformation of cervical spine adds Q05.0; it is not part of this code and both may be reported when both are documented.

    Full comparison: Q16.3 vs Q05.0 →

  • Q05.5— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of congenital malformation of cervical spine adds Q05.5; it is not part of this code and both may be reported when both are documented.

    Full comparison: Q16.3 vs Q05.5 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Congenital malformation of ear ossicles is a billable ICD-10-CM diagnosis code (Q16.3).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name Q16.3 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: Q17 — Other congenital malformations of ear.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 3 MS-DRGs: DRG 154 (MDC 03), DRG 155 (MDC 03), DRG 156 (MDC 03).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):MAL005 — Congenital malformations of eye, ear, face, neck (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Congenital malformations of eye, ear, face, neck).

Q14.2 — Congenital malformation of optic disc, Q14.3 — Congenital malformation of choroid, Q14.8 — Other congenital malformations of posterior segment of eye, Q14.9 — Congenital malformation of posterior segment of eye, unspecified, Q15.0 — Congenital glaucoma, Q15.8 — Other specified congenital malformations of eye, Q15.9 — Congenital malformation of eye, unspecified, Q16.0 — Congenital absence of (ear) auricle, Q16.1 — Congenital absence, atresia and stricture of auditory canal (external), Q16.2 — Absence of eustachian tube, Q16.4 — Other congenital malformations of middle ear, Q16.5 — Congenital malformation of inner ear, Q16.9 — Congenital malformation of ear causing impairment of hearing, unspecified, Q17.0 — Accessory auricle, Q17.1 — Macrotia, Q17.2 — Microtia, Q17.3 — Other misshapen ear, Q17.4 — Misplaced ear, Q17.5 — Prominent ear, Q17.8 — Other specified congenital malformations of ear, +41 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Accessory”, “Malformation”, “Distortion”, …; these codes share that main term but sit in a different category of the Tabular List.

Q13.9 — Congenital malformation of anterior segment of eye, unspecified (eye, anterior segment), Q14.0 — Congenital malformation of vitreous humor (hyaloid, artery), Q14.1 — Congenital malformation of retina (retina), Q14.2 — Congenital malformation of optic disc (optic disc), Q14.3 — Congenital malformation of choroid (choroid), Q14.8 — Other congenital malformations of posterior segment of eye (hyaloid, system), Q14.9 — Congenital malformation of posterior segment of eye, unspecified (eye, posterior segment), Q15.0 — Congenital glaucoma (Axenfeld's), Q15.8 — Other specified congenital malformations of eye (eye), Q15.9 — Congenital malformation of eye, unspecified (eye), Q17.0 — Accessory auricle (ear), Q17.1 — Macrotia (ear, external, macrotia), Q17.2 — Microtia (ear, external, microtia), Q17.3 — Other misshapen ear (ear), Q17.4 — Misplaced ear (congenital, ear), Q17.5 — Prominent ear (ear, external, prominence), Q17.8 — Other specified congenital malformations of ear (ear, lobe), Q17.9 — Congenital malformation of ear, unspecified (ear), Q18.0 — Sinus, fistula and cyst of branchial cleft (branchial cleft NOS, cyst), Q18.2 — Other branchial cleft malformations (branchial cleft), +680 more

Contextual Map

Every relationship of Q16.3 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run Q16.3 with this related code in Claim Check

Hierarchy

Referenced by Excludes1 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 03 — Diseases and Disorders of the Ear, Nose, Mouth and Throat[MDC crossing]: “Diseases and Disorders of the Ear, Nose, Mouth and Throat — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 5,151 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries (23)

  • Absence (of) (organ or part) (complete or partial), ear, congenital, middle, except ossicles, ossicles[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Absence (of) (organ or part) (complete or partial), ear, congenital, ossicles[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Absence (of) (organ or part) (complete or partial), incus (acquired), congenital[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Accessory (congenital), auditory ossicles[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Agenesis, incus[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Anomaly, anomalous (congenital) (unspecified type), ear (external), ossicles[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Anomaly, anomalous (congenital) (unspecified type), middle ear, ossicles[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Deformity, ear (acquired), congenital (external), middle, ossicles[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • and 15 more

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (23)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "Q16.3 — Congenital malformation of ear ossicles." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/q16.3-congenital-malformation-of-ear-ossicles

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Congenital malformation of ear ossicles

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Q16.3 in its code family, with their registry titles.

View all codes in the Q16 family